JDF 222 R8 - 17 NOTICE OF APPEAL AND DESIGNATION OF RECORD CRIMINAL County Court District Court County, Colorado Court Address: State of Colorado/Appellee: v. Defendant /Appellant : COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom NOTICE OF APPEAL AND DESIGNATION OF RECORD - CRIMINAL The Defendant her e by files an appeal in (County Court case number) for the following reason (s) : At this time, I request a stay of execution. I understand that as a condition of the stay of execution, I may be required to post a bond or deposit the amount of fines and costs assessed. Current information about the Appellant /Defendant : Full Name: Mailing Address: City & Zip: Home Phone #: Work P hone #: Cell #: Designation of Record: The clerk of court will prepare the record on appeal, pursuant to Rule 37 , Rules of C riminal Procedure and will include the following items : The county court case fil e, including all pleadings, motions, reports, exhibits, orders of the court, and jury instructions, if applicable. The original transcript : ( identify proceedings) . By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. Date: Signature of Defendant/ Appellant Signature of Attorney for Defendant/ Appellant, if applicable CERTIFICATE OF SERVICE I certify that on (date) an original was filed with the Court and that a true and accurate copy of th is NOTICE OF APPEAL /DESIGNATION OF RECORD - CRIMINAL was provided to other party by: Hand Delivery or Faxed to this number or by placing it in the United St ates mail, postage pre - paid, and addressed to the following: To: Signature American LegalNet, Inc. www.FormsWorkFlow.com